Smart coordination to save lives

I have served my country around the world as a career diplomat for 33 years now.  I’ve seen firsthand what successful cooperation among governments and citizens can accomplish in the pursuit of shared goals. 
Yet, one of the strongest examples of results-focused partnerships underway is what I am now witnessing unfold in the Kingdom of Lesotho, to improve life-saving health services and win the fight against HIV and Aids.  It is smart collaboration that relies on country-driven solutions and maximises the effectiveness of American development dollars.
Here in Lesotho, more than 23 percent of the adult population is estimated to be HIV-positive — the third highest rate in the world.  The United Nations projects that this rate will climb to an even higher 36 percent over the next 15 years, leading to a further drop in life expectancy and robbing Lesotho of a healthy and productive workforce vital to its economic growth and prosperity.  Sick people, after all, cannot work or contribute to the country’s long-term economic development.
It comes as no surprise that one of Lesotho’s top national priorities is HIV and Aids education, prevention, counselling and treatment.  A national “Know Your Status” campaign was launched to test the entire population of some 1.9 million citizens. 
And part of Lesotho’s strategy to deliver sustainable solutions to this pressing health epidemic entails working with the donor community, including such US government agencies as the Millennium Challenge Corporation (MCC) and the President’s Emergency Plan for Aids Relief (PEPFAR).
The coordination between MCC and PEPFAR to help the government and people of Lesotho overcome the HIV and Aids crisis, is one of the best I have seen in all my years of service. 
Part of Lesotho’s US$362.6 million MCC grant — an innovative performance-based approach to development that invests in the growth priorities determined by the people of Lesotho themselves — is funding critical infrastructure renovations at up to 150 existing health centres and 14 district hospital out-patient departments, over a five-year period. 
To complement such MCC-funded infrastructure improvements, PEPFAR, through its US$140 million Partnership Framework, is investing in the human resource capacity necessary to deliver health services at these renovated facilities, like training nurses and testing and counselling pregnant women.  Both MCC and PEPFAR are contributing their unique core competencies to a complementary synergy of action that is saving lives.
Just ask the mothers and children of Lesotho.  As of 2007, more than 90 percent of Lesotho’s women visited clinics during their pregnancy. An estimated 40 percent of those were HIV-positive, and 83 percent received treatment for the prevention of mother-to-child transmission (PMTCT) of HIV.
However, only 50 percent of all women in the country actually deliver in health facilities, and for those who do not, there is no way to ensure that they are taking the HIV treatment appropriately, resulting in many more children born with HIV.
PEPFAR is particularly focused on PMTCT and expects that MCC-renovated facilities with maternity wards, will encourage more women to deliver at health centres.  This will allow PEPFAR to better monitor if mothers and babies are taking HIV-treatments appropriately. 
Ultimately, such strong MCC-PEPFAR coordination will allow many more babies to be born HIV-free and enjoy a healthy start on life.
With results like this materialising in Lesotho, American taxpayers can rest assured that their resources are being invested wisely.  At a time of global economic challenges, it is imperative that we seek and implement ways that leverage American assistance so that it complements, not duplicates, efforts on the ground and that it reflects the priorities of partner countries themselves, not outside donors. 
This is how real progress is unfolding in Lesotho in the critical national fight against HIV and Aids, and I am proud that American aid, through MCC and PEPFAR, is contributing effectively to this reality.  It is a model of smart coordination worth emulating elsewhere around the world.

• Nolan has served as US Ambassador to the Kingdom of Lesotho since 2007.

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